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COVID-19 患者的并发症:肺栓塞的特征。

Complications in COVID-19 patients: Characteristics of pulmonary embolism.

机构信息

Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554, Monserrato (Cagliari) 09045, Italy.

Department of Radiology, Ospedale S. Giovanni Bosco, 10154 Turin, Italy.

出版信息

Clin Imaging. 2021 Sep;77:244-249. doi: 10.1016/j.clinimag.2021.05.016. Epub 2021 May 18.

Abstract

OBJECTIVE

The purpose of this study is to evaluate chest CT imaging features, clinical characteristics, laboratory values of COVID-19 patients who underwent CTA for suspected pulmonary embolism. We also examined whether clinical, laboratory or radiological characteristics could be associated with a higher rate of PE.

MATERIALS AND METHODS

This retrospective study included 84 consecutive patients with laboratory-confirmed SARS-CoV-2 who underwent CTA for suspected PE. The presence and localization of PE as well as the type and extent of pulmonary opacities on chest CT exams were examined and correlated with the information on comorbidities and laboratory values for all patients.

RESULTS

Of the 84 patients, pulmonary embolism was discovered in 24 patients. We observed that 87% of PE was found to be in lung parenchyma affected by COVID-19 pneumonia. Compared with no-PE patients, PE patients showed an overall greater lung involvement by consolidation (p = 0.02) and GGO (p < 0.01) and a higher level of D-Dimer (p < 0,01). Moreover, the PE group showed a lower level of saturation (p = 0,01) and required more hospitalization (p < 0,01).

CONCLUSION

Our study showed a high incidence of PE in COVID-19 pneumonia. In 87% of patients, PE was found in lung parenchyma affected by COVID-19 pneumonia with a worse CT severity score and a greater number of lung lobar involvement compared with non-PE patients. CT severity, lower level of saturation, and a rise in D-dimer levels could be an indication for a CTPA.

ADVANCES IN KNOWLEDGE

Certain findings of non-contrast chest CT could be an indication for a CTPA.

摘要

目的

本研究旨在评估因疑似肺栓塞而行 CTA 的 COVID-19 患者的胸部 CT 影像学特征、临床特征和实验室值。我们还研究了临床、实验室或影像学特征是否与更高的 PE 发生率相关。

材料与方法

本回顾性研究纳入了 84 例经实验室确诊的 SARS-CoV-2 患者,这些患者因疑似 PE 而行 CTA。检查胸部 CT 检查中 PE 的存在和定位,以及肺部混浊的类型和程度,并将其与所有患者的合并症和实验室值信息相关联。

结果

84 例患者中,24 例发现有肺栓塞。我们发现,87%的 PE 发生在 COVID-19 肺炎累及的肺实质中。与无 PE 患者相比,PE 患者的实变(p=0.02)和磨玻璃影(p<0.01)的总体肺受累程度更大,D-二聚体水平更高(p<0.01)。此外,PE 组的血氧饱和度较低(p=0.01),需要更多的住院治疗(p<0.01)。

结论

我们的研究显示 COVID-19 肺炎中 PE 的发生率较高。在 87%的患者中,PE 发生在 COVID-19 肺炎累及的肺实质中,与非 PE 患者相比,CT 严重程度评分更高,肺叶受累更多。CT 严重程度、较低的血氧饱和度和 D-二聚体水平升高可能提示需要进行 CTPA。

知识进展

非增强胸部 CT 的某些发现可能提示需要进行 CTPA。

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